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There are little clinics popping up all over Texas. The state has been building big hospitals over the last decade. Then there’s the two medical schools under construction at the moment.

All of those facilities send their waste to the sewer, just like everyone else. But there are problems with this arrangement. A large percentage of hospital-borne infections are from superbugs – antibiotic-resistant bacteria – that nobody knows how to control.

So what happens to those superbugs once they are in the sewage stream? Dr. Pedro Alvarez is the director of Rice University’s Nanotechnology-Enabled Water Treatment effort. He says wastewater treatment plants are like a “luxury hotel” for these multi-drug resistant bacteria.

“In wastewater treatment plants, we rely on bacteria to biodegrade pollutants,” Alvarez says. “They proliferate, and essentially they grow so that wastewater treatment plants may become breeding grounds for some of these (drug resistant) bacteria, as well.”

Medical facilities have always disposed of wastewater just like any other utility user. The problem, Alvarez says, is that the increasing use of antibiotics is making these bugs more common.

“As we increase the use of these antibacterial agents, mainly in hospitals but also in animal agriculture – which is a major environmental load – these bacteria are becoming increasingly resistant to common antibiotics and they’re very hard to treat.”

Alvarez says the way to prevent the problem for reaching pandemic levels in the future is to take a multi-faceted approach now.

“On the policy side, we need to encourage less misuse and abuse of antibiotics, perhaps treat some of the waste streams from hospitals before they reach the sewage,” he says. “There is considerable room here for technological innovation to disinfect better and to destroy not only the resistant bacteria, but the genes that they may transfer to other bacteria in the environment.”